Rocuronium may provide a longer duration of a safe apneic period in patients with a high risk of desaturation.

A nasal cannula set at 15 L/minute is effective at providing oxygenation during the apneic period.

Background:

Intubation is a vital procedure to the Emergency Physician. Yet there is more to it than just placing an endotracheal tube. There is the setup, positioning, oxygenation, sedation, checking tube placement, and more. On top of this, there is the underlying illness to consider. The truth is, the majority of patients intubated in the Emergency Department (ED) are sick. Something is very physiologically wrong, and they are not maintaining adequate oxygenation. It becomes your job to do this for them. The authors in this article did an extensive literature review on pre-intubation and peri-intubation techniques which reduce the risk of hypoxia in the adult patient requiring intubation in the ED. Continue reading →